Topical steroid alone vs a combination with a posterior segment NSAID after Nd-YAG capsulotomy: Is the posterior segment NSAID really necessary?

PURPOSE: To compare the effect of topical 1% prednisolone acetate and 0.09% bromfenac versus topical 1% prednisolone acetate alone on macular thickness following Nd: YAG laser capsulotomy. MATERIALS AND METHODS: About 150 eyes with posterior capsule opacification following were included. All patients were treated with Nd: YAG laser posterior capsulotomy. Patients were randomly divided into two groups of 75. Group 1-Patients received: Topical 1% prednisolone acetate and Topical 0.09% bromfenac. Group 2-Patients received: Topical 1% prednisolone acetate alone. Outcome measures by an independent observer were BCVA by Snellen chart, IOP by NCT, and Central Macular Thickness (CMT) by Macular OCT. All patients were examined before the procedure, 1 h after the procedure, at 1 week, and at 6 weeks. STATISTICS: 1. Quantitative variables: Mann-Whitney Test and Wilcoxon ranked sum test. 2. Qualitative variables: Chi-square test. A P value of < 0.05 was considered statistically significant. RESULTS: Mean IOP increase in both groups is statistically significant at 1 h and later decreases back to nonsignificant levels at 1 week and 6 weeks. No significant change in mean CMT was seen in the duration of 6 weeks neither in Group 1 nor Group 2. CONCLUSION: Prophylactic antiglaucoma medications are not recommended in patients undergoing Nd: YAG laser capsulotomy. No evidence of cystoid macular edema was recorded till the end of 6 weeks follow-up.